Leptospirosis

Leptospirosis is a bacterial disease that affects humans and animals. It is caused by bacteria of the genus Leptospira. In humans, it can cause a wide range of symptoms, some of which may be mistaken for other diseases. Some infected persons, however, may have no symptoms at all.

Without treatment, Leptospirosis can lead to kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, respiratory distress, and even death.

Infection

The bacteria that cause leptospirosis are spread through the urine of infected animals, which can get into water or soil and can survive there for weeks to months. Many different kinds of wild and domestic animals carry the bacterium.

These can include, but are not limited to:

• Cattle
• Pigs
• Horses
• Dogs
• Rodents
• Wild animals

When these animals are infected, they may have no symptoms of the disease.

Infected animals may continue to excrete the bacteria into the environment continuously or every once in a while for a few months up to several years.

Humans can become infected through:

Contact with urine (or other body fluids, except saliva) from infected animals.

Contact with water, soil, or food contaminated with the urine of infected animals.

The bacteria can enter the body through skin or mucous membranes (eyes, nose, or mouth), especially if the skin is broken from a cut or scratch. Drinking contaminated water can also cause infection. Outbreaks of leptospirosis are usually caused by exposure to contaminated water, such as floodwaters. Person to person transmission is rare.

Symptoms

You usually start showing signs of leptospirosis within 2 weeks, though in some cases, symptoms may not show up for a month or not at all.

When the disease does hit, it hits fast. You’ll get a fever. It may spike to 104 F. Other typical symptoms include:

• Headache
• Muscle ache
• Jaundice (yellowing of the skin and eyes)
• Vomiting
• Diarrhea
• Skin rash

Many of these symptoms are similar to other diseases, including the flu and meningitis, so it’s important to get tested.

To check for leptospirosis, your doctor does a simple blood test and examines the blood for antibodies. These are organisms your body produces to fight the bacteria. If you have had the disease in your system before, the blood test may give a false positive (or show antibodies from the previous infection). So your doctor will likely do a second test about a week later to make sure the results are correct.

Your doctor could order a DNA test. It’s more precise, but is more expensive and takes longer, and in many areas of the world, it’s not available yet. The bacteria can also be detected if it grows in a blood, spinal fluid, or urine culture

The Leptospira bacteria can exist in raccoons, bats, sheep, dogs, mice, rats, horses, cattle, buffaloes, and pigs.

The bacteria inhabit the animals’ kidneys and are expelled through urination, infecting the soil or water supplies.

The bacteria can remain in the soil or water for months.

Causes

The Legionella bacteria exist in rivers, lakes and other places with fresh water, but numbers are usually low because the water temperature in such places is too low for the bacteria to multiply rapidly.

In artificial water systems, however, water temperatures may be higher.

Temperatures between 68 and 113 degrees Fahrenheit, or from 20 to 45 degrees Celsius, can be ideal for the bacteria to multiply rapidly and spread.

This can infect major parts of the water system.

An ideal environment also provides the right food. Impurities, such as algae, sludge, rust, and lime scale are types of food for this sort of bacteria.

Hotels, hospitals, and large buildings can provide the ideal environment, if they have an air-conditioning system that uses water for cooling.

Other types of artificial water systems that can potentially become contaminated include fountains, baths, showers, water taps, gardening sprinklers, spas, and humidifiers.

Risk factors

Some risk factors can make a person more susceptible to Legionnaire’s disease.

Age: It is more likely to affect people over 50 years old.

Existing health conditions: People with respiratory problems, including smokers, patients with chronic obstructive pulmonary disease (COPD) and those with lung cancer, are at higher risk.

A weakened immune system: Patients with diabetes, kidney disease, leukemia and other cancers, and who are undergoing chemotherapy are at greater risk, as their immune system is compromised.

Lifestyle factors: Heavy alcohol consumption increases the risk, and one study has suggested that using cannabis may increase susceptibility.

A report from the CDC suggestsTrusted Source that newborns delivered in a birthing tub, or water birth, may be at risk of Legionnaire’s disease.

From 2011 to 2015, there was only one case of an infant contracting the disease before the age of 1 month. However, in the first 4 months of 2016, two infants were treated for Legionnaire’s disease, and both were born in a home birthing tub.

Exams and Tests

The blood is tested for antibodies to the bacteria. During some phases of the illness, the bacteria themselves can be detected using polymerase chain reaction (PCR) testing.

Other tests that may be done:

• Complete blood count (CBC)
• Creatine kinase
• Liver enzymes
• Urinalysis
• Blood cultures
• Treatment
• Medicines to treat leptospirosis include:
• Ampicillin
• Azithromycin
• Ceftriaxone
• Doxycycline
• Penicillin

Complicated or serious cases may need supportive care. You may need treatment in a hospital intensive care unit (ICU).

Leptospirosis can be treated with antibiotics, including penicillin and doxycycline. Your doctor may also recommend ibuprofen for fever and muscle pain.

The disease should run its course in about a week.But, you may have to go to the hospital if your infection is more severe. Symptoms may include kidney failure, meningitis, and lung problems. You may need to have antibiotics injected into your body, and in very serious cases, the infection could damage your organs.

Treatment in cases of complications can vary. For example, the disease can spread through your body (systemic inflammatory syndrome) and cause internal bleeding and inflame your pancreas or gallbladder. You or those around you might notice changes in your speech or behavior after the spread of this infection.

It also could inflame the heart muscle (myocarditis), leading to symptoms of heart failure including blockages and an irregular heartbeat (dysrhythmia). Your doctor will assess your other symptoms, overall health, health history, age, and other factors before deciding how to treat these complications.

How Can You Prevent It?

Avoid contaminated water. If you’re in a developing country, don’t drink the water unless you’re sure it’s clean. But because leptospirosis can enter through other body openings, it’s also a good idea to avoid swimming, waterskiing, sailing, or fishing in freshwater areas. Saltwater is generally safe